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Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis

Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis
Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis

Aims: to examine associations of assisted reproductive technology (ART) conception (vs. natural conception: NC) with offspring cardiometabolic health outcomes and whether these differ with age.

Methods and results: differences in systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), lipids, and hyperglycaemic/insulin resistance markers were examined using multiple linear regression models in 14 population-based birth cohorts in Europe, Australia, and Singapore, and results were combined using meta-analysis. Change in cardiometabolic outcomes from 2 to 26 years was examined using trajectory modelling of four cohorts with repeated measures. 35 938 (654 ART) offspring were included in the meta-analysis. Mean age ranged from 13 months to 27.4 years but was <10 years in 11/14 cohorts. Meta-analysis found no statistical difference (ART minus NC) in SBP (-0.53 mmHg; 95% CI:-1.59 to 0.53), DBP (-0.24 mmHg; -0.83 to 0.35), or HR (0.02 beat/min; -0.91 to 0.94). Total cholesterol (2.59%; 0.10-5.07), HDL cholesterol (4.16%; 2.52-5.81), LDL cholesterol (4.95%; 0.47-9.43) were statistically significantly higher in ART-conceived vs. NC offspring. No statistical difference was seen for triglycerides (TG), glucose, insulin, and glycated haemoglobin. Long-term follow-up of 17 244 (244 ART) births identified statistically significant associations between ART and lower predicted SBP/DBP in childhood, and subtle trajectories to higher SBP and TG in young adulthood; however, most differences were not statistically significant.

Conclusion: these findings of small and statistically non-significant differences in offspring cardiometabolic outcomes should reassure people receiving ART. Longer-term follow-up is warranted to investigate changes over adulthood in the risks of hypertension, dyslipidaemia, and preclinical and clinical cardiovascular disease.

Humans, Young Adult, Adult, Infant, Hypertension, Cardiovascular Diseases/epidemiology, Cohort Studies, Blood Pressure/physiology, Triglycerides, Reproductive Techniques, Assisted/adverse effects
0195-668X
1464-1473
Elhakeem, Ahmed
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Taylor, Amy E.
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Inskip, Hazel M.
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Huang, Jonathan Y.
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Mansell, Toby
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Rodrigues, Carina
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Asta, Federica
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Blaauwendraad, Sophia M.
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Håberg, Siri E.
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Halliday, Jane
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Manios, Yannis
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McCarthy, Fergus P.
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Reiss, Irwin K.M.
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Salika, Theodosia
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Tafflet, Muriel
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Qiu, Xiu
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Åsvold, Bjørn O.
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Burgner, David
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Chan, Jerry K.Y.
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Gagliardi, Luigi
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Gaillard, Romy
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Heude, Barbara
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Magnus, Maria C.
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Porta, Daniela
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Saffery, Richard
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Barros, Henrique
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Eriksson, Johan G.
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Vrijkotte, Tanja G.M.
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Lawlor, Deborah A.
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Elhakeem, Ahmed
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Taylor, Amy E.
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Inskip, Hazel M.
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Huang, Jonathan Y.
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Mansell, Toby
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Rodrigues, Carina
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Asta, Federica
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Blaauwendraad, Sophia M.
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Håberg, Siri E.
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Halliday, Jane
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Harskamp-van Ginkel, Margreet W.
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He, Jian-Rong
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Jaddoe, Vincent W.V.
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Lewis, Sharon
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Maher, Gillian M.
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Manios, Yannis
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McCarthy, Fergus P.
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Reiss, Irwin K.M.
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Rusconi, Franca
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Salika, Theodosia
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Tafflet, Muriel
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Qiu, Xiu
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Åsvold, Bjørn O.
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Burgner, David
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Chan, Jerry K.Y.
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Gagliardi, Luigi
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Gaillard, Romy
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Heude, Barbara
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Moschonis, George
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Murray, Deirdre
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Nelson, Scott M.
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Porta, Daniela
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Saffery, Richard
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Barros, Henrique
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Eriksson, Johan G.
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Vrijkotte, Tanja G.M.
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Lawlor, Deborah A.
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Elhakeem, Ahmed, Taylor, Amy E., Inskip, Hazel M., Huang, Jonathan Y., Mansell, Toby, Rodrigues, Carina, Asta, Federica, Blaauwendraad, Sophia M., Håberg, Siri E., Halliday, Jane, Harskamp-van Ginkel, Margreet W., He, Jian-Rong, Jaddoe, Vincent W.V., Lewis, Sharon, Maher, Gillian M., Manios, Yannis, McCarthy, Fergus P., Reiss, Irwin K.M., Rusconi, Franca, Salika, Theodosia, Tafflet, Muriel, Qiu, Xiu, Åsvold, Bjørn O., Burgner, David, Chan, Jerry K.Y., Gagliardi, Luigi, Gaillard, Romy, Heude, Barbara, Magnus, Maria C., Moschonis, George, Murray, Deirdre, Nelson, Scott M., Porta, Daniela, Saffery, Richard, Barros, Henrique, Eriksson, Johan G., Vrijkotte, Tanja G.M. and Lawlor, Deborah A. (2023) Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis. European Heart Journal, 44 (16), 1464-1473. (doi:10.1093/eurheartj/ehac726).

Record type: Article

Abstract

Aims: to examine associations of assisted reproductive technology (ART) conception (vs. natural conception: NC) with offspring cardiometabolic health outcomes and whether these differ with age.

Methods and results: differences in systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), lipids, and hyperglycaemic/insulin resistance markers were examined using multiple linear regression models in 14 population-based birth cohorts in Europe, Australia, and Singapore, and results were combined using meta-analysis. Change in cardiometabolic outcomes from 2 to 26 years was examined using trajectory modelling of four cohorts with repeated measures. 35 938 (654 ART) offspring were included in the meta-analysis. Mean age ranged from 13 months to 27.4 years but was <10 years in 11/14 cohorts. Meta-analysis found no statistical difference (ART minus NC) in SBP (-0.53 mmHg; 95% CI:-1.59 to 0.53), DBP (-0.24 mmHg; -0.83 to 0.35), or HR (0.02 beat/min; -0.91 to 0.94). Total cholesterol (2.59%; 0.10-5.07), HDL cholesterol (4.16%; 2.52-5.81), LDL cholesterol (4.95%; 0.47-9.43) were statistically significantly higher in ART-conceived vs. NC offspring. No statistical difference was seen for triglycerides (TG), glucose, insulin, and glycated haemoglobin. Long-term follow-up of 17 244 (244 ART) births identified statistically significant associations between ART and lower predicted SBP/DBP in childhood, and subtle trajectories to higher SBP and TG in young adulthood; however, most differences were not statistically significant.

Conclusion: these findings of small and statistically non-significant differences in offspring cardiometabolic outcomes should reassure people receiving ART. Longer-term follow-up is warranted to investigate changes over adulthood in the risks of hypertension, dyslipidaemia, and preclinical and clinical cardiovascular disease.

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Accepted/In Press date: 23 November 2022
e-pub ahead of print date: 6 February 2023
Published date: 21 April 2023
Keywords: Humans, Young Adult, Adult, Infant, Hypertension, Cardiovascular Diseases/epidemiology, Cohort Studies, Blood Pressure/physiology, Triglycerides, Reproductive Techniques, Assisted/adverse effects

Identifiers

Local EPrints ID: 490894
URI: http://eprints.soton.ac.uk/id/eprint/490894
DOI: doi:10.1093/eurheartj/ehac726
ISSN: 0195-668X
PURE UUID: bbc5567e-596c-488c-86da-7750fde6c116
ORCID for Hazel M. Inskip: ORCID iD orcid.org/0000-0001-8897-1749

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Date deposited: 07 Jun 2024 17:43
Last modified: 08 Jun 2024 01:35

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Contributors

Author: Ahmed Elhakeem
Author: Amy E. Taylor
Author: Hazel M. Inskip ORCID iD
Author: Jonathan Y. Huang
Author: Toby Mansell
Author: Carina Rodrigues
Author: Federica Asta
Author: Sophia M. Blaauwendraad
Author: Siri E. Håberg
Author: Jane Halliday
Author: Margreet W. Harskamp-van Ginkel
Author: Jian-Rong He
Author: Vincent W.V. Jaddoe
Author: Sharon Lewis
Author: Gillian M. Maher
Author: Yannis Manios
Author: Fergus P. McCarthy
Author: Irwin K.M. Reiss
Author: Franca Rusconi
Author: Theodosia Salika
Author: Muriel Tafflet
Author: Xiu Qiu
Author: Bjørn O. Åsvold
Author: David Burgner
Author: Jerry K.Y. Chan
Author: Luigi Gagliardi
Author: Romy Gaillard
Author: Barbara Heude
Author: Maria C. Magnus
Author: George Moschonis
Author: Deirdre Murray
Author: Scott M. Nelson
Author: Daniela Porta
Author: Richard Saffery
Author: Henrique Barros
Author: Johan G. Eriksson
Author: Tanja G.M. Vrijkotte
Author: Deborah A. Lawlor

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